Obligate chimerism in male yellow crazy ants

Multicellular organisms typically develop from a single fertilized egg and therefore consist of clonal cells. We report an extraordinary reproductive system in the yellow crazy ant. Males are chimeras of haploid cells from two divergent lineages: R and W. R cells are overrepresented in the males' somatic tissues, whereas W cells are overrepresented in their sperm. Chimerism occurs when parental nuclei bypass syngamy and divide separately within the same egg. When syngamy takes place, the diploid offspring either develops into a queen when the oocyte is fertilized by an R sperm or into a worker when fertilized by a W sperm. This study reveals a mode of reproduction that may be associated with a conflict between lineages to preferentially enter the germ line.

Efficacy and safety of moxidectin and albendazole compared to ivermectin and albendazole co-administration in adolescents infected with Trichuris trichiura: a randomized controlled trial protocol

Background: Infections with soil-transmitted helminths (STHs) predominantly affect impoverished populations in tropical environments. The periodic administration of single dose benzimidazoles (i.e., albendazole, mebendazole) to at-risk individuals in endemic regions is at the center of STH control strategies. Given the low efficacy of these drugs against trichuriasis, investigation of drug combinations including moxidectin and ivermectin has recently been initiated, yet the identification of the best treatment option requires more research. We present the protocol for a trial investigating the efficacy and safety of co-administered moxidectin and albendazole compared to co-administered ivermectin and albendazole against Trichuris trichiura.

Methods: We will conduct a randomized controlled trial enrolling 540 T. trichiura-infected adolescents aged 12-19 years on Pemba Island (Tanzania). The trial will be open-label with blinded outcome assessors. The primary objective is to demonstrate non-inferiority of orally co-administered single-dose moxidectin (8 mg)/albendazole (400 mg) compared to orally co-administered single-dose ivermectin (200 µg/kg)/albendazole (400 mg) in terms of egg reduction rates (ERRs) against T. trichiura infections assessed by Kato-Katz at 14-21 days post-treatment. Secondary objectives include the assessment of the drug combinations’ superiority compared to their respective monotherapies, of the cure rates (CRs) against T. trichiura, and the safety and tolerability of all treatments, as well as CRs and ERRs against concomitant STH infections ( Ascaris lumbricoides and hookworm). Potential effects of the treatment regimens on follow-up prevalences of STH at 5-6 weeks and 3 months post-treatment and pharmacokinetic/  pharmacodynamic parameters will also be assessed.

Conclusions: Results from this trial will help to inform decision- and policymakers on which anthelminthic combination therapy might improve existing deworming programs and provide a valuable adjunct tool for interrupting STH transmission.

Clinicaltrials.govregistration: NCT04700423 (07/01/2021)

Efficacy and safety of moxidectin and albendazole compared to ivermectin and albendazole co-administration in adolescents infected with Trichuris trichiura: a randomized controlled trial protocol

Background: Infections with soil-transmitted helminths (STHs) predominantly affect impoverished populations in tropical environments. The periodic administration of single dose benzimidazoles (i.e., albendazole, mebendazole) to at-risk individuals in endemic regions is at the center of STH control strategies. Given the low efficacy of these drugs against trichuriasis, investigation of drug combinations including moxidectin and ivermectin has recently been initiated, yet the identification of the best treatment option requires more research. We present the protocol for a trial investigating the efficacy and safety of co-administered moxidectin and albendazole compared to co-administered ivermectin and albendazole against Trichuris trichiura. Methods: We will conduct a randomized controlled trial enrolling 540 T. trichiura-infected adolescents aged 12-19 years on Pemba Island (Tanzania). The primary objective is to demonstrate non-inferiority of orally co-administered single-dose moxidectin (8 mg)/albendazole (400 mg) compared to orally co-administered single-dose ivermectin (200 µg/kg)/albendazole (400 mg) in terms of egg reduction rates (ERRs) against T. trichiura infections assessed by Kato-Katz at 14-21 days post-treatment. Secondary objectives include the assessment of the drug combinations’ superiority compared to their respective monotherapies, of the cure rates (CRs) against T. trichiura, and the safety and tolerability of all treatments, as well as CRs and ERRs against concomitant STH infections (Ascaris lumbricoides and hookworm). Potential effects of the treatment regimens on follow-up prevalences of STH at 5-6 weeks and 3 months post-treatment, infection status derived by quantitative polymerase chain reaction (qPCR), and pharmacokinetic/  pharmacodynamic parameters will also be assessed. Furthermore, a subsample of stool specimens will be analyzed by an updated version of the FECPAKG2 platform. Conclusions: Results from this trial will help to inform decision- and policymakers on which anthelminthic combination therapy might improve existing deworming programs and provide a valuable adjunct tool for interrupting STH transmission. Clinicaltrials.gov registration: NCT04700423 (07/01/2021)

Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania

Background

Preventive chemotherapy is the cornerstone of soil-transmitted helminth (STH) control. Long-term outcomes and adequate treatment frequency of the recently recommended albendazole-ivermectin have not been studied to date.

Methodology/principal findings

Double-blind randomized controlled trials were conducted in Lao PDR, Pemba Island, Tanzania and Côte d’Ivoire between 2018 and 2020 to evaluate the efficacy and safety of ivermectin-albendazole versus albendazole-placebo in Trichuris trichiura-infected individuals aged 6 to 60. In the framework of this study, in Lao PDR 466 and 413 participants and on Pemba Island, 558 and 515 participants were followed-up six and 12 months post-treatment, respectively. From each participant at least one stool sample was processed for Kato-Katz diagnosis and cure rates (CRs), egg reduction rates (ERRs) and apparent reinfection rates were calculated. If found helminth-positive at six months, participants were re-treated according to their allocated treatment.

Long-term outcomes against T. trichiura based on CRs and ERRs of ivermectin-albendazole compared to albendazole were significantly higher at six months in Lao PDR (CR, 65.8 vs 13.4%, difference; 52.4; 95% CI 45.0–60.0; ERRs, 99.0 vs 79.6, difference 19.4; 95% CI 14.4–24.4) and Pemba Island (CR, 17.8 vs 1.4%, difference; 16.4; 95% CI 11.6–21.0; ERRs, 84.9 vs 21.2, difference 63.8; 95% CI 50.6–76.9) and also at 12 months in Lao PDR (CR, 74.0 vs 23.4%, difference; 50.6; 95% CI 42.6–61.0; ERRs, 99.6 vs 91.3, difference 8.3; 95% CI 5.7–10.8) and Pemba Island (CR, 19.5 vs 3.4%, difference; 16.1; 95% CI 10.7–21.5; ERRs, 92.9 vs 53.6, difference 39.3; 95% CI 31.2–47.4) respectively.

Apparent reinfection rates with T. trichiura were considerably higher on Pemba Island (100.0%, 95% CI, 29.2–100.0) than in Lao PDR (10.0%, 95% CI, 0.2–44.5) at 12 months post-treatment for participants treated with albendazole alone.

Conclusions/significance

The long-term outcomes against T. trichiura of ivermectin-albendazole are superior to albendazole in terms of CRs and ERRs and in reducing infection intensities. Our results will help to guide decisions on how to best use ivermectin-albendazole in the context of large-scale PC programs tailored to the local context to sustainably control STH infections.

Trial registration

ClinicalTrials.gov registered with clinicaltrials.gov, reference: NCT03527732, date assigned: 17 May 2018.

Around 1.5 billion people are infected with the gastrointestinal dwelling nematodes, the so-called soil-transmitted helminths (STHs). Especially chronic high-intensity infections with these parasites can cause substantial morbidity in endemic regions. Preventive chemotherapy, which is the regular administration of a single dose of an anthelmintic drug to at-risk populations, aims to reduce morbidity by lowering the prevalence and intensity of STH infections. Due to the suboptimal efficacy of these recommended single dose monotherapies, particularly against Trichuris trichiura, the use of drug combinations with dissimilar modes of action may enhance treatment efficacy. In double-blind randomized controlled trials in Lao PDR and on Pemba Island, Tanzania, we examined the long-term outcomes of ivermectin-albendazole versus albendazole alone, against T. trichiura. We assessed the infection status, apparent reinfections, new infections and the change of infection intensity for the three major STH species six and 12 months post-treatment. The long-term outcomes (in terms of cure and egg-reduction rates) of the ivermectin-albendazole combination therapy against T. trichiura were significantly higher than that of albendazole alone at all-time points and in both countries. Bi-annual treatment intervals using the ivermectin-albendazole combination might be necessary to sustainably decrease transmission of STH infections.

Assessment of fecal calprotectin and fecal occult blood as point-of-care markers for soil-transmitted helminth attributable intestinal morbidity in a case-control substudy conducted in Côte d'Ivoire, Lao PDR and Pemba Island, Tanzania

BACKGROUND

Infections with soil-transmitted helminths (STHs) may result in chronic inflammatory disorders affecting the human host. The objective of this study was to evaluate Fecal Calprotectin (FC) and Fecal Occult Blood (FOB) in individuals infected and non-infected with STHs to identify potential intestinal morbidity markers.

METHODS

Stool from participants diagnosed positive for Trichuris trichiura and concomitant STH infections from three countries was used to perform FC and FOB point-of-care assays. Simultaneously, identified STH negative participants underwent FC and FOB testing as controls. Potential associations between test results and determinants were analyzed using multivariable logistic regression.

FINDINGS

In total, 1034 T. trichiura infected cases (mostly light infections) and 157 STH negative controls were tested for FC and FOB. Among all participants tested, 18·5% had ≥ 50 µg/g FC concentration, while 14 (1·2%) were positive for FOB. No statistically significant association was found between T. trichiura infection or Ascaris lumbricoides co-infection and FC concentration, while an inverse association (odds ratio (OR): 0·45, 95% credible intervals (CrI): 0·26, 0·75) was found between hookworm co-infection and FC concentration. In Lao PDR, the proportion of participants in the ≥ 50 µg/g FC category was significantly higher in the oldest age category compared to the 5-11 years group (OR: 3·31, 95% CrI: 1·62, 7·24). Too few participants were found positive for FOB to derive any conclusions.

INTERPRETATION

Studies are needed to better understand the relationship between intestinal morbidity and STH infections. Suitable, standardized, low-cost markers of STH attributable morbidity to better monitor the impact of STH control interventions are necessary.

FUNDING

BMGF (OPP1153928).

Efficacy and Safety of Ascending Dosages of Moxidectin and Moxidectin-albendazole Against Trichuris trichiura in Adolescents: A Randomized Controlled Trial

BACKGROUND

Preventive chemotherapy is the main strategy to control soil-transmitted helminth (STH) infections. Albendazole and mebendazole are ubiquitously used, but they are not sufficiently effective against Trichuris trichiura. Moxidectin might be a useful addition to the small drug armamentarium. However, the optimal dosage of moxidectin alone and in combination with albendazole against T. trichiura and other STHs has not yet been determined.

METHODS

A Phase II, randomized, placebo-controlled, dose-finding trial was conducted in 2 secondary schools on Pemba Island, Tanzania. Using a computer-generated list, T. trichiura-infected adolescents were randomly assigned to 7 treatment arms: 8, 16, or 24 mg of moxidectin monotherapy; 8, 16, or 24 mg of moxidectin plus 400 mg of albendazole combination therapy; or placebo. The primary outcome was cure rate (CR) against T. trichiura, analyzed 13 to 20 days after treatment by quadruple Kato-Katz thick smears.

RESULTS

A total of 290 adolescents were enrolled (41 or 42 per arm). CRs against T. trichiura were 43, 46, and 44% for 8, 16, and 24 mg of moxidectin alone, respectively; 60, 62, and 66% for the same moxidectin dosages plus 400 mg of albendazole, respectively; and 12% for placebo. The moxidectin-albendazole arms also revealed higher CRs and egg reduction rates against hookworm than the monotherapy arms. Moxidectin and its combination with albendazole were well tolerated.

CONCLUSIONS

Moxidectin-albendazole is superior to moxidectin. There is no benefit of using doses above 8 mg, which is the recommended dose for onchocerciasis. The moxidectin-albendazole combination of 8 mg plus 400 mg should be investigated further to develop recommendations for appropriate control of STH infections.

CLINICAL TRIALS REGISTRATION

NCT03501251.

Performance of the Kato-Katz method and real time polymerase chain reaction for the diagnosis of soil-transmitted helminthiasis in the framework of a randomised controlled trial: treatment efficacy and day-to-day variation

BACKGROUND

Accurate, scalable and sensitive diagnostic tools are crucial in determining prevalence of soil-transmitted helminths (STH), assessing infection intensities and monitoring treatment efficacy. However, assessments on treatment efficacy comparing traditional microscopic to newly emerging molecular approaches such as quantitative Polymerase Chain Reaction (qPCR) are scarce and hampered partly by lack of an established diagnostic gold standard.

METHODS

We compared the performance of the copromicroscopic Kato-Katz method to qPCR in the framework of a randomized controlled trial on Pemba Island, Tanzania, evaluating treatment efficacy based on cure rates of albendazole monotherapy versus ivermectin-albendazole against Trichuris trichiura and concomitant STH infections. Day-to-day variability of both diagnostic methods was assessed to elucidate reproducibility of test results by analysing two stool samples before and two stool samples after treatment of 160 T. trichiura Kato-Katz positive participants, partially co-infected with Ascaris lumbricoides and hookworm, per treatment arm (n = 320). As negative controls, two faecal samples of 180 Kato-Katz helminth negative participants were analysed.

RESULTS

Fair to moderate correlation between microscopic egg count and DNA copy number for the different STH species was observed at baseline and follow-up. Results indicated higher sensitivity of qPCR for all three STH species across all time points; however, we found lower test result reproducibility compared to Kato-Katz. When assessed with two samples from consecutive days by qPCR, cure rates were significantly lower for T. trichiura (23.2 vs 46.8%), A. lumbricoides (75.3 vs 100%) and hookworm (52.4 vs 78.3%) in the ivermectin-albendazole treatment arm, when compared to Kato-Katz.

CONCLUSIONS

qPCR diagnosis showed lower reproducibility of test results compared to Kato-Katz, hence multiple samples per participant should be analysed to achieve a reliable diagnosis of STH infection. Our study confirms that cure rates are overestimated using Kato-Katz alone. Our findings emphasize that standardized and accurate molecular diagnostic tools are urgently needed for future monitoring within STH control and/or elimination programmes.

[Gut microbiome and anorexia nervosa : The relationship between microbiome and gut-brain interaction in the context of anorexia nervosa]

In recent years the intestinal microbiome and its interaction with the brain has aroused a growing interest. The findings gained in the course of this research are of great relevance not only to basic scientists but also to clinicians, as studies suggest an association between an altered microbiome and various somatic (e.g. chronic inflammatory intestinal diseases, obesity and diabetes) as well as psychiatric diseases (e.g. anxiety disorders, depression). In addition to a direct influence of the microbiome on the brain and behavior, various mechanisms seem to be relevant, including altered energy intake from food, hormonal changes, probably increased intestinal permeability as well as inflammatory and immunological processes. Anorexia nervosa (AN) is the third most common chronic disease in adolescence and has the highest mortality rate among all mental disorders. In addition to extremely restrictive eating habits, weight loss and comorbid anxiety and depression symptoms, endocrine changes and an increased autoimmune and inflammatory response are characteristic. Since AN is particularly strongly linked to eating behavior and nutrition, research into the microbiome seems very promising, especially with respect to this disease. This article gives a first insight into the underlying processes that play a role in gut-brain interaction in the context of AN and summarizes the previous empirical findings on this topic. Finally, an outlook on future research and possible implications for the therapeutic practice and treatment of AN is given.

Tunable anomalous Hall conductivity through volume-wise magnetic competition in a topological kagome magnet

Magnetic topological phases of quantum matter are an emerging frontier in physics and material science. Along these lines, several kagome magnets have appeared as the most promising platforms. Here, we explore magnetic correlations in the kagome magnet Co3Sn2S2. Using muon spin-rotation, we present evidence for competing magnetic orders in the kagome lattice of this compound. Our results show that while the sample exhibits an out-of-plane ferromagnetic ground state, an in-plane antiferromagnetic state appears at temperatures above 90 K, eventually attaining a volume fraction of 80% around 170 K, before reaching a non-magnetic state. Strikingly, the reduction of the anomalous Hall conductivity (AHC) above 90 K linearly follows the disappearance of the volume fraction of the ferromagnetic state. We further show that the competition of these magnetic phases is tunable through applying either an external magnetic field or hydrostatic pressure. Our results taken together suggest the thermal and quantum tuning of Berry curvature induced AHC via external tuning of magnetic order.

Efficacy and safety of ivermectin and albendazole co-administration in school-aged children and adults infected with Trichuris trichiura: study protocol for a multi-country randomized controlled double-blind trial

BACKGROUND

Soil-transmitted helminthiasis affects almost 2 billion people worldwide in tropical climates. Preventive chemotherapy, using the benzimidazoles (albendazole and mebendazole) is the current main recommended control strategy. Nevertheless, there is limited efficacy of these drugs against hookworm infection and, to a greater extent, against trichuriasis. We describe a protocol for a trial investigating the efficacy and safety of the co-administration of ivermectin and albendazole against trichuriasis.

METHODS

A double-blind, placebo-controlled randomized controlled trial will be conducted in three countries (Côte d'Ivoire, Tanzania and Lao PDR) with the aim to determine the efficacy, safety and extended effects of co-administered ivermectin and albendazole compared to standard albendazole monotherapy. We will enroll 600 participants aged 6-60 years in each setting. The primary outcome is cure rate (CR) against Trichuris trichiura infection as assessed by Kato-Katz 14-21 days after treatment. Secondary outcomes include CRs against concomitant soil-transmitted helminth (STH) infections (Ascaris lumbricoides, hookworm and Strongyloides stercoralis) and egg reduction rates (ERRs) against STH at 14-21 days, 180 days and 360 days. Tolerability of treatment, infection status assessed by polymerase chain reaction (PCR), and potential benefits of deworming on nutritional and morbidity indicators will be assessed. The primary analysis will include an available-case set and use logistic regression models adjusted for age, sex and weight.

DISCUSSION

This trial will provide robust results on the efficacy and safety of co-administration of ivermectin and albendazole with the aim to better inform WHO recommendations on control of STHs. Furthermore, secondary and explanatory outcomes will provide direct evidence on the extended effects of combination therapy and insight on the relationship between nutrition and morbidity parameters and infection status and intensity.

TRIAL REGISTRATION

NCT03527732 (date assigned: 17 May 2018).

Pauling Entropy, Metastability, and Equilibrium in Dy_{2}Ti_{2}O_{7} Spin Ice

Determining the fate of the Pauling entropy in the classical spin ice material Dy_{2}Ti_{2}O_{7} with respect to the third law of thermodynamics has become an important test case for understanding the existence and stability of ice-rule states in general. The standard model of spin ice-the dipolar spin ice model-predicts an ordering transition at T≈0.15  K, but recent experiments by Pomaranski et al. suggest an entropy recovery over long timescales at temperatures as high as 0.5 K, much too high to be compatible with the theory. Using neutron scattering and specific heat measurements at low temperatures and with long timescales (0.35  K/10^{6}  s and 0.5  K/10^{5}  s, respectively) on several isotopically enriched samples, we find no evidence of a reduction of ice-rule correlations or spin entropy. High-resolution simulations of the neutron structure factor show that the spin correlations remain well described by the dipolar spin ice model at all temperatures. Furthermore, by careful consideration of hyperfine contributions, we conclude that the original entropy measurements of Ramirez et al. are, after all, essentially correct: The short-time relaxation method used in that study gives a reasonably accurate estimate of the equilibrium spin ice entropy due to a cancellation of contributions.

Bone Marrow Stromal Cells Promote Innervation of Bioengineered Teeth

Transplantation of bone marrow mesenchymal stem cells (BMDCs) into a denervated side of the spinal cord was reported to be a useful option for axonal regeneration. The innervation of teeth is essential for their function and protection but does not occur spontaneously after injury. Cultured reassociations between dissociated embryonic dental mesenchymal and epithelial cells and implantation lead to a vascularized tooth organ regeneration. However, when reassociations were coimplanted with a trigeminal ganglion (TG), innervation did not occur. On the other hand, reassociations between mixed embryonic dental mesenchymal cells and bone marrow-derived cells isolated from green fluorescent protein (GFP) transgenic mice (BMDCs-GFP) (50/50) with an intact and competent dental epithelium (ED14) were innervated. In the present study, we verified the stemness of isolated BMDCs, confirmed their potential role in the innervation of bioengineered teeth, and analyzed the mechanisms by which this innervation can occur. For that purpose, reassociations between mixed embryonic dental mesenchymal cells and BMDCs-GFP with an intact and competent dental epithelium were cultured and coimplanted subcutaneously with a TG for 2 wk in ICR mice. Axons entered the dental pulp and reached the odontoblast layer. BMDCs-GFP were detected at the base of the tooth, with some being present in the pulp associated with the axons. Thus, while having a very limited contribution in tooth formation, they promoted the innervation of the bioengineered teeth. Using quantitative reverse transcription polymerase chain reaction and immunostainings, BMDCs were shown to promote innervation by 2 mechanisms: 1) via immunomodulation by reducing the number of T lymphocytes (CD3+, CD25+) in the implants and 2) by expressing neurotrophic factors such as NGF, BDNF, and NT3 for axonal growth. This strategy using autologous mesenchymal cells coming from bone marrow could be used to innervate bioengineered teeth without treatment with an immunosuppressor such as cyclosporine A (CsA), thus avoiding multiple side effects.

Dipolar Spin Ice States with a Fast Monopole Hopping Rate in CdEr_{2}X_{4} (X=Se, S)

Excitations in a spin ice behave as magnetic monopoles, and their population and mobility control the dynamics of a spin ice at low temperature. CdEr_{2}Se_{4} is reported to have the Pauling entropy characteristic of a spin ice, but its dynamics are three orders of magnitude faster than the canonical spin ice Dy_{2}Ti_{2}O_{7}. In this Letter we use diffuse neutron scattering to show that both CdEr_{2}Se_{4} and CdEr_{2}S_{4} support a dipolar spin ice state-the host phase for a Coulomb gas of emergent magnetic monopoles. These Coulomb gases have similar parameters to those in Dy_{2}Ti_{2}O_{7}, i.e., dilute and uncorrelated, and so cannot provide three orders faster dynamics through a larger monopole population alone. We investigate the monopole dynamics using ac susceptometry and neutron spin echo spectroscopy, and verify the crystal electric field Hamiltonian of the Er^{3+} ions using inelastic neutron scattering. A quantitative calculation of the monopole hopping rate using our Coulomb gas and crystal electric field parameters shows that the fast dynamics in CdEr_{2}X_{4} (X=Se, S) are primarily due to much faster monopole hopping. Our work suggests that CdEr_{2}X_{4} offer the possibility to study alternative spin ice ground states and dynamics, with equilibration possible at much lower temperatures than the rare earth pyrochlore examples.

Immune mediated destruction of platelets in dogs with heat stroke: A prospective study

Objective: Severe thrombocytopenia is a common sequelae to heat stroke in dogs. So far it has been hypothezised that it is due to disseminated intravascular coagulation. We hypothezised that it is due to immune mediated destruction via antiplatelet antibodies. Material and methods: Prospective evaluation of dogs with heat stroke from May 2005 to August 2008. Dogs that developed severe thrombocytopenia within 5 days of admission were included in the study. All dogs were treated with a standardized treatment protocol. In addition, they received either immunoglobulins or prednisolone. Results: Six dogs were presented with heat stroke during that time period. Four developed a severe thrombocytopenia. All four dogs tested positive for antiplatelet antibodies and did not have elevated D-Dimers at that time. Platelet count in three dogs recovered fully, one dog was euthanized due to liver and renal failure. Conclusion: In those cases thrombocytopenia was due to immune mediated destruction not due to DIC. Clinical rele-vance: Due to the severity of the thrombocytopenia and the high risk for bleeding in those patients, immunosuppressive therapy in addition to DIC prophylaxis should be discussed.

Fallbericht und Literaturübersicht kutaner Dirofilariose

Gegenstand und Ziel: Der Fallbericht erörtert das diagnostische Vorgehen und differenzialdiagnostische Überlegungen bei Patienten mit Mikrofilarämie und negativem Dirofilaria-immitis-Antigentest und diskutiert die Infektion mit Dirofilaria repens und deren Therapie. Material und Methode: Bei einem Hund aus Ungarn wurden im Blutausstrich Mikrofilarien gefunden. Die weitere Diagnostik zur Differenzierung der Mikrofilarien umfasste einen Dirofilaria-immitis-Antigentest, eine Polymerasekettenreaktion zum Nachweis von Dirofilaria immitis und Dipetalonema reconditum sowie eine Saure-Phosphatase-Reaktion zur Diagnose einer Infektion mit Dirofilaria repens. Ergebnisse: Mittels der Saure-Phosphatase-Reaktion konnte eine Infektion mit Dirofilaria repens diagnostiziert werden. Die Therapie gegen die Mikrofilarien erfolgte mit Selamectin. Schlussfolgerung und klinische Relevanz: Bei mikrofilarämischen Patienten muss differenzialdiagnostisch neben einer Infektion mit Dirofilaria immitis eine Infektion mit anderen, weniger pathogenen Parasiten in Betracht gezogen werden, da sich die Notwendigkeit einer Therapie und das Therapieregime je nach Infektion deutlich unterscheiden.

World Health Organization cardiovascular risk stratification and target organ damage

BACKGROUND

Prediction charts allow treatment to be targeted according to simple markers of cardiovascular risk; many algorithms do not recommend screening asymptomatic target organ damage which could change dramatically the assessment.

OBJECTIVE

To demonstrate that target organ damage is present in low cardiovascular risk hypertensive patients and it is more frequent and severe as global cardiovascular risk increases.

METHODS

Consecutive hypertensive patients treated at a single Latin American center. Cardiovascular risk stratified according to 2013 WHO/ISH risk prediction chart America B. Left ventricular mass assessed by Devereux method, left ventricular hypertrophy considered >95g/m(2) in women and >115g/m(2) in men. Transmitral diastolic peak early flow velocity to average septal/lateral peak early diastolic relaxation velocity (E/e' ratio) measured cut off value >13. Systolic function assessed by tissue Doppler average interventricular septum/lateral wall mitral annulus rate systolic excursion (s wave).

RESULTS

A total of 292 patients were included of whom 159 patients (54.5%) had cardiovascular risk of <10%, 90 (30.8%) had cardiovascular risk of 10-20% and 43 (14.7%) had cardiovascular risk of >20%. Left ventricular hypertrophy was detected in 17.6% low risk patients, 27.8% in medium risk and 23.3% in high risk (p<0.05), abnormal E/e' ratio was found in 13.8%, 31.1% and 27.9%, respectively (p<0.05). Mean s wave was 8.03+8, 8.1+9 and 8.7+1cm/s for low, intermediate and high risk patients, respectively (p<0.025).

CONCLUSIONS

Target organ damage is more frequent and severe in high risk; one over four subjects was misclassified due to the presence of asymptomatic target organ damage.

Chitosan-based nanocomposites for the repair of bone defects

Chitosan scaffolds of different deacetylation degrees, average molecular weights and concentrations reinforced with silica nanoparticles were prepared for bone tissue regeneration. The resulting nanocomposites showed similar pore sizes (<300 μm) regardless the deacetylation degree and concentration used in their formulation. Their mechanical compression resistance was increased by a 30% with the addition of silica nanoparticles as nanofillers. The biocompatibility of the three-dimensional chitosan scaffolds was confirmed by the Alamar Blue assay in human primary osteoblasts as well as the formation of cell spheroids indicative of their great potential for bone regeneration. In vivo implantation of the scaffolds in a mice calvaria defect model provided substantial evidences of the suitability of these nanocomposites for bone tissue engineering showing a mature and dense collagenous tissue with small foci of mineralization, vascularized areas and the infiltration of osteoblasts and osteoclasts. Nevertheless, mature bone tissue formation was not observed after eight weeks of implantation.

Polydomy enhances foraging performance in ant colonies

Collective foraging confers benefits in terms of reduced predation risk and access to social information, but it heightens local competition when resources are limited. In social insects, resource limitation has been suggested as a possible cause for the typical decrease in per capita productivity observed with increasing colony size, a phenomenon known as Michener's paradox. Polydomy (distribution of a colony's brood and workers across multiple nests) is believed to help circumvent this paradox through its positive effect on foraging efficiency, but there is still little supporting evidence for this hypothesis. Here, we show experimentally that polydomy enhances the foraging performance of food-deprived Temnothorax nylanderi ant colonies via several mechanisms. First, polydomy influences task allocation within colonies, resulting in faster retrieval of protein resources. Second, communication between sister nests reduces search times for far away resources. Third, colonies move queens, brood and workers across available nest sites in response to spatial heterogeneities in protein and carbohydrate resources. This suggests that polydomy represents a flexible mechanism for space occupancy, helping ant colonies adjust to the environment.

Abstract P5-09-06: Ovarian reserve and response to controlled ovarian hyperstimulation (COH) in breast cancer women with and without BRCA mutation

Background: 6300 new cases of breast cancer arise in young women under 40 each year in France. Some of them are BRCA 1 or 2 mutation carriers. Most of them receive a potentially gonadotoxic chemotherapy while they have not yet completed their family. Since 2011, a systematic proposal of ovarian reserve follow-up and fertility preservation by oocyte freezing is provided to each young early breast cancer (BC) patients (pts) of our program (NCT 01614704). Preliminary results were presented at the SABCS in 2013. We now investigate the impact of BRCA mutation on the ovarian reserve and the ovarian response to simulation.

Methods: 115 young BC pts were systematically referred to a reproductive medicine centre before starting chemotherapy. Inclusion criteria were age 18 to 38, histologically confirmed invasive breast carcinoma, absence of metastases. According to their personal and familial history, genetic counselling was performed and if the patient met the criteria and agreed, BRCA genes were analysed. Pts in an adjuvant setting and who were asking for fertility preservation underwent COH during the interval between complete surgery and start of adjuvant chemotherapy. Ovarian stimulation protocol consisted in a conventional antagonist protocol with recombinant FSH starting on day 2 of the menstrual cycles. The GnRh antagonist was started on day of the COH and the final oocyte maturation was achieved by an injection of triptorelin 0.2 mg when at least 3 follicles reached 18 mm of diameter. All pts gave their informed consent for COH, egg/embryo freezing and follow-up.

Results: 115 pts achieved pre-treatment AMH and AFC assessment. 60 (52,1%) were eligible for COH in order to cryopreserve egg or embryos. BRCA analysis was performed in 83 pts. 23 did not meet the criteria or refused. 9 analyses are still in process. 17 (20.4%) pts were positive for BRCA mutation (BRCA1: 13; BRCA2: 4) and 66 were not. In the mutation carriers group (n=17), median age was 32 years (Range 25-37). Median initial AMH levels and AFC were 23 pmol/l (5.1–223) and 20 (6-100), respectively. Eight pts underwent COH. Median duration of stimulation was 9,5 days (8-13) with a median cumulative dose of gonadotropins of 2875 UI (1200-5450). The median number of vitrified oocytes was 5,5 (0-15). Two patients chose frozen embryo preservation (1 and 2 eggs respectively). In the non-carriers group (n=66), median age was 31 years (24-37). Median initial AMH levels and AFC were 23.4 pmol/l (0.8-136) and 24 (1-68). 27 pts underwent COH. Median duration of stimulation was 10 days (7-14). Dose of gonadotropins was 2700 UI (1365-5600). The median number of vitrified oocytes was 6 (0-18). The 3 patients chose eggs preservation (0.0 and 3 eggs respectively). There was no significant difference in the two groups.

Discussion/ Conclusion: Few studies stated that BRCA1 mutation may be associated with reduced ovarian reserve in healthy BRCA mutation carriers. Meirow and al concluded that both healthy and BC BRCA mutation carriers demonstrated normal ovarian response in vitro fertilization cycles. Our results show that ovarian reserve of BRCA 1/2 mutations BC carriers do not differ from that of non-carriers. Response to COH seems similar in both groups too.

Citation Format: Mailliez A, Keller L, Menu-Hespel S, Plouvier P, D'Orazio E, Basson L, Pigny P, Bonneterre J, Decanter C. Ovarian reserve and response to controlled ovarian hyperstimulation (COH) in breast cancer women with and without BRCA mutation [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-09-06.

The Genovese grading scale is not reliable for MR assessment of collagen meniscus implants

BACKGROUND

The purpose of the study was to evaluate the intra- and inter-observer reliabilities of the Genovese grading on MRI in patients after collagen meniscus substitution.

METHODS

84 MRI images of 74 consecutive patients who underwent partial meniscus substitution using collagen meniscus implant (CMI) were assessed. MRIs were evaluated using the Genovese grading system. Furthermore, meniscal extrusion was assessed. Two observers performed the grading twice, blinded to each other and to the previous results, with a six weeks interval. The inter- and intra-observer reliabilities were assessed using kappa and weighted kappa values.

RESULTS

The criterion "morphology/size" showed a weighted kappa value inter-observer reliability of 0.069 (rater 1)/0.352 (rater 2) and intra-observer reliability of 0.170 (1st rating)/0.582 (2nd rating). The criterion "signal intensity" showed a weighted kappa value inter-observer reliability of 0.175/0.284 and intra-observer reliability of 0.294/0.458. The criterion "cartilage lesions" showed a kappa value inter-observer reliability of 0.091/0.525 and intra-observer reliability of 0.409/0.413. The criterion "bone marrow edema" showed a kappa value inter-observer reliability of 0.667/0.808 and intra-observer reliability of 0.702/0.715. The criterion "cartilage lesions" showed a kappa value inter-observer reliability of 0.091/0.525 and intra-observer reliability of 0.409/0.413. Regarding meniscal extrusion kappa values for the inter-observer reliability were 0.625/0.940 and 0.625/0.889 for intra-observer reliability.

CONCLUSIONS

Three of the four Genovese grading items showed only slight to moderate inter- and intra-observer reliabilities in evaluating CMI on MRI. Hence, such grading results need to be considered with all due care. Only the criteria "bone marrow edema" and "meniscal extrusion" showed a good agreement for both inter- and intra-observer reliabilities.

A novel type of splayed ferromagnetic order observed in Yb2Ti2O7

The pyrochlore insulator Yb2Ti2O7 has attracted the attention of experimentalists and theoreticians alike for about 15 years. Conflicting neutron diffraction data on the possible existence of magnetic Bragg reflections at low temperature have been published. Here we report the observation of magnetic Bragg reflections by neutron powder diffraction at 60 mK. The magnetic diffraction pattern is analyzed using representation theory. We find Yb2Ti2O7 to be a splayed ferromagnet as reported for Yb2Sn2O7, a sibling compound with also dominating ferromagnetic interactions as inferred from the positive Curie-Weiss temperature. However, the configuration of the magnetic moment components perpendicular to the easy axis is of the all-in-all-out type in Yb2Ti2O7 while it is two-in-two-out in the Yb2Sn2O7. An overall experimental picture of the magnetic properties emerges.

Morphologic and Functional Heart Abnormalities Associated to High Modified Tei Index in Hypertensive Patients

INTRODUCTION

LV dysfunction develops early in hypertension, even previously to left ventricular remodeling.

AIMS

To determine the frequency of morphologic and functional heart abnormalities associated to abnormal modified Tei Index in untreated hypertensive (HBP) patients (p) with preserved ejection fraction (pEF).

METHODS

Case-control study. Three groups: (1) HBP without left ventricular hypertrophy (LVH); (2) HBP with LVH; (3) non-HBP controls. Ejection fraction >54 % identified pEF. LVH measured by Devereux method. Systolic and diastolic functions assessed by standard echocardiography and tissue Doppler. 2013 ESH/ESC Hypertension Guidelines normal values were considered. Tei index measured at the lateral and septal LV walls in apical 4-chamber view by tissue Doppler, value >0.40 considered abnormal.

STATISTICAL ANALYSIS

multifactorial ANOVA test adjusted by sex and age, p < 0.05 statistically significant.

RESULTS

The study included 14 controls, 88 HBP p without LVH, and 19 HBP p with LVH. The HBP p sample mean age was 58.7 ± 13.5 years and 52 (44.1 %) were males. Mean Tei Index was 0.35 ± 0.03 in controls; 0.42 ± 0.05 in HBP without LVH; and 0.42 ± 0.06 in HBP with LVH (p < 0.025). Abnormal Tei Index was present in 2p (14.3 %) controls; 64 p (72.7 %) HBP without LVH; and 15 p (78.9 %) HBP with LVH (p < 0.0009). Tissue Doppler's wave was 8.4 ± 0.9 cm/s in controls; 8 ± 1.6 cm/s in HBP without LVH and 7.8 ± 1.1 cm/s in HBP with LVH.

CONCLUSIONS

(1) Left ventricular dysfunction is frequent in HBP p, even without LVH; (2) modified tissue Doppler Tei index is a useful tool for the diagnosis of left ventricular dysfunction.

Three-dimensional Micro-culture System for Tooth Tissue Engineering

The arrangement of cells within a tissue plays an essential role in organogenesis, including tooth development. Progress is being made to regenerate teeth by reassociating dissociated embryonic dental cells and implanting them in vivo. In the present study, we tested the hanging drop method to study mixed epithelial-mesenchymal cell reorganization in a liquid instead of semisolid medium to see whether it could lead to tooth histogenesis and organogenesis. This method allowed the control of the proportion and number of cells to be used, and the forming microtissues showed homogeneous size. The liquid environment favored cell migrations as compared with collagen gels. Three protocols were compared. The one that sequentially combined the hanging drop and semisolid medium cultures prior to in vivo implantation gave the best results. Indeed, after implantation, teeth developed, showing a well-formed crown, mineralization of dentin and enamel, and the initiation of root formation. Vascularization and the cellular heterogeneity in the mesenchyme were similar to what was observed in developing molars. Finally, after coimplantation with a trigeminal ganglion, the dental mesenchyme, including the odontoblast layer, became innervated. The real advantage of this technique is the small number of cells required to make a tooth. This experimental model can be employed to study the development, physiology, metabolism, or toxicology in forming teeth and test other cell sources.

New insights into the magnetic properties of LaErO3, (La0.5Er0.5)2O3 and (La0.5Dy0.5)2O3 oxides

Orthorhombic LaErO3 and cubic (La0.5 Ln 0.5)2O3 oxides (Ln: Er, Dy) were examined by neutron powder diffraction between 1.5 K and 15 K in order to investigate their crystallographic and magnetic structures. At 1.5 K both LaErO3 and (La0.5Er0.5)2O3 display a magnetic moments ordering, whereas for (La0.5Dy0.5)2O3 only short range magnetic correlations can be argued, suggesting a possible magnetic moments ordering at lower temperature. LaErO3 is characterized by a magnetic wavevector k  =  (0, 0, 0) and forms an antiferromagnetic G x C y A z -type structure belonging to the [Formula: see text] Shubnikov group with a total magnetic moment of 6.78(3) μ B. The antiferromagnetic structure of (La0.5Er0.5)2O3 is similar to the one typical of Er2O3, with a total magnetic moment of 4.28(2) μ B at both different magnetic sites; it is characterized by k  =  (0, 0, 0) and belongs to the magnetic [Formula: see text] Shubnikov group.

Layer-preferential substitutions and magnetic properties of pyrrhotite-type Fe7-yMyX8 chalcogenides (X = S, Se; M = Ti, Co)

A comparative study of four series of pyrrhotite-type chalcogenide compounds Fe(7-y)M(y)X(8) (X = S, Se) with substitution of Ti or Co for iron has been performed by means of x-ray and neutron powder diffraction, and by magnetization measurements. In Fe(7-y)M(y)X(8) compounds having a ferrimagnetic order at y = 0, the substitution of either Ti or Co for iron is observed to result in a monotonous decrease of the magnetic ordering temperature, while the resultant magnetization shows a non-monotonous behavior with a minimum around y = 1.0-1.5 in all the Fe(7-y)M(y)X(8) families except Fe(7-y)Co(y)Se(8). Suppression of a magnetically ordered state with substitutions in Fe(7-y)M(y)X(8) is ascribed to nearly zero values of Ti and Co magnetic moments, while the non-monotonous changes of the resultant magnetization are explained by the compensation of the sublattice magnetizations due to the non-random substitutions in alternating metallic layers. The difference in the cation partitioning observed in Fe(7-y)Ti(y)X(8) and Fe(7-y)Co(y)X(8) is attributed to the difference in the spatial extension of Ti and Co 3d orbitals. High coercive field values (20-24 kOe) observed at low temperatures in the Ti-containing compounds Fe(7-y)Ti(y)X(8) with y ⩾ 3 are suggested to result from the enhancement of Fe orbital moment due to the Ti for Fe substitution.

High pressure induced spin state crossover in Sr2CaYCo4O10.5

The layered cobaltite Sr(2)CaYCo(4)O(10.5) with formal average cobalt oxidation state close to 3+ has been studied as functions of both temperature and pressure up to 4 GPa by neutron powder diffraction (NPD). The crystal structure is shown to have tetragonal symmetry (space group I4/mmm; 2a(p) × 2a(p) × 4a(p) superstructure), and the magnetic structure at ambient pressure is found to be G-type antiferromagnetic with TN close to 310 K. The magnetic moments within the CoO(6) octahedral layers and anion-deficient CoO(4.5) layers are 1.2μ(B) and 2.8μ(B), respectively. At 25 K, and applied pressure of 3.5 GPa is sufficient to completely suppress a long-range magnetic order. This result is interpreted in terms of a pressure-induced high-to-low spin state crossover of the Co(3+) ions.

Expression of foraging and Gp-9 are associated with social organization in the fire ant Solenopsis invicta

The aim of this study was to investigate levels of expression of two major genes, the odorant binding protein Gp-9 (general protein-9) and foraging, that have been shown to be associated with behavioural polymorphisms in ants. We analysed workers and young nonreproductive queens collected from nests of the monogyne (single reproductive queen per nest) and polygyne (multiple reproductive queens) social forms of Solenopsis invicta. In workers but not young queens, the level of foraging expression was significantly associated with social form and the task performed (ie localization in the nest or foraging area). The level of expression of Gp-9 was also associated with social form and worker localization. In addition there was a higher level of expression of the Gp-9(b) allele compared with the Gp-9(B) allele in the heterozygote workers and the young nonreproductive queens. Finally, in the polygyne colonies the level of expression of foraging was not significantly associated with the Gp-9 genotype for either workers or young nonreproductive queens, suggesting that both genes have independent non-epistatic effects on behaviour in S. invicta.

Nanomechanical Properties of Active Nanofibrous Implants After In Vivo Bone Regeneration

With the aging of the population and a correlated increase in the incidence of osteoarticular damage, great attention is focused on regenerative nanomedicine solutions to restore durable articular function and comfort. A durable cartilage repair is not effective without regeneration of an intact subchondral bed along with the surface chondral regeneration. Our expected outcomes are the development of clinical applications in the field of tissue engineering and nanomedicine, and more particularly in bone-cartilage unit regeneration. Here we report for the first time the nanomechanical analysis of the retrieved active implant after subchondral bone regeneration in vivo, which is much more efficient and long lasting solution to osteochondral defects than the existing ones. We believe that our results make a significant contribution to the area of regenerative nanomedicine. The concepts discovered here may serve to design sophisticated implants for placement into a broad variety of tissues.

Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer's disease

Eleven susceptibility loci for late-onset Alzheimer's disease (LOAD) were identified by previous studies; however, a large portion of the genetic risk for this disease remains unexplained. We conducted a large, two-stage meta-analysis of genome-wide association studies (GWAS) in individuals of European ancestry. In stage 1, we used genotyped and imputed data (7,055,881 SNPs) to perform meta-analysis on 4 previously published GWAS data sets consisting of 17,008 Alzheimer's disease cases and 37,154 controls. In stage 2, 11,632 SNPs were genotyped and tested for association in an independent set of 8,572 Alzheimer's disease cases and 11,312 controls. In addition to the APOE locus (encoding apolipoprotein E), 19 loci reached genome-wide significance (P < 5 × 10(-8)) in the combined stage 1 and stage 2 analysis, of which 11 are newly associated with Alzheimer's disease.

DC magnetic susceptibility and neutron powder diffraction analysis of the perovskite-type compounds LaYbO₃ and LaHoO₃

Magnetization measurements and neutron powder diffraction analyses followed by Rietveld refinement have been carried out in order to investigate the magnetic structures of LaYbO3 and LaHoO3. Both compounds exhibit a negative thermal expansion along the a and b axes. In LaYbO3 Yb(3+) spins order at 2.4 K according to a FyGz-type structure, belonging to the Pn'ma' magnetic space group. Conversely, LaHoO3 is paramagnetic down to 1.5 K.

ES cells-derived ectomesenchymal cells for tooth engineering

Recent progresses in stem cell biology and tissue engineering allow considering the possible development of new therapies for compensating the dental tissue losses associated with traumas, pathologies or ageing. The possibility of generating a tooth by mimicking development through reassociations between dental epithelial cells and ectomesenchymal cells derived from the neural crest (NC) has been demonstrated in the mouse. In the search of cell sources to be used for a human transfer, pluripotent stem cells could represent a good alternative. Our study thus focuses on obtaining, ectomesenchymal cells from pluripotent ES cells, capable of promoting tooth histomorphogenesis, when reassociated with a competent dental epithelium. To this end, two ES differentiation protocols, using cyclopamine or a combination of FGF2 and BMP4, have been developed and tested for their capacity to generate such cells. The differentiated ES cells were characterized by quantitative RT-PCR. Both protocols led the cells to acquire in 10 days a mesenchymal-like cell morphology. Rapidly after induction, the cells loose their expression of pluripotent genes while sequentially activating typical NC specifiers. However, the kinetics of gene activation differed between the 2 protocols. Interestingly, Twist, a gene whose expression in the NC is associated with a commitment towards an ectomesenchymal fate, is only activated under the influence of FGF2 and BMP4. Reassociation experiments with a competent epithelium will allow testing the odontogenic potential of the differentiated ES cells. These experiments performed in the mouse system should allow defining a strategy for obtaining odontogenic competent human cells.

Field induced incommensurate-to-commensurate magnetic phase transition in Ca₃Co₁.₈Fe₀.₂O₆: a neutron diffraction study

Neutron powder diffraction experiments have been performed to investigate the nature of magnetic ordering, as a function of temperature (1.5-100 K) and magnetic field (0, 2 and 4 T), in the compound Ca3Co1.8Fe0.2O6. In zero applied field, the compound orders magnetically in the incommensurate spin density wave (SDW) structure (TN ∼ 20 K). Under an applied field of ∼2 T, an incommensurate-to-commensurate magnetic phase transition has been observed. With a further increase in the magnetic field (∼4 T), the commensurate magnetic structure transforms into a ferrimagnetic structure. In zero applied field, magnetic short-range ordering (SRO) coexists with the SDW long-range ordering (LRO) at all temperatures below TN. In an applied magnetic field (2 and 4 T), SRO is converted into LRO only over the temperature range 12-20 K; however, below ∼12 K, an increase in the volume fraction of the SRO has been observed. The correlation length for the SRO (below ∼12 K) also gets affected by the application of a field.

Dynamical splayed ferromagnetic ground state in the quantum spin ice Yb(2)Sn(2)O(7)

From magnetic, specific heat, (170)Yb Mössbauer effect, neutron diffraction, and muon spin relaxation measurements on polycrystalline Yb(2)Sn(2)O(7), we show that below the first order transition at 0.15 K all of the Yb(3+) ions are long-range magnetically ordered and each has a moment of 1.1 μ(B) which lies at ≃ 10° to a common fourfold cubic axis. The four sublattice moments have four different directions away from this axis and are therefore noncoplanar. We term this arrangement splayed ferromagnetism. This ground state has a dynamical component with a fluctuation rate in the megahertz range. The net ferromagnetic exchange interaction has an anisotropy that favors the local threefold axis. We discuss our results in terms of the phase diagram proposed by Savary and Balents [Phys. Rev. Lett. 108, 037202 (2012)] for a pyrochlore lattice of Kramers 1/2 effective spins.

One-year clinical and MR imaging outcome after partial meniscal replacement in stabilized knees using a collagen meniscus implant

PURPOSE

The purpose of the study was to evaluate the clinical and radiological outcomes after medial/lateral collagen meniscus substitution (CMI) at 12 months postoperatively.

METHODS

Sixty-seven patients (m:f = 47:20, mean age 36 ± 10 years) underwent arthroscopic CMI after previous subtotal medial (n = 55) or lateral meniscectomy (n = 12) due to persistent joint line pain (n = 25) or to prophylactic reasons (n = 42). Clinical follow-up consisted of IKDC score, Tegner score, Lysholm score, and visual analog scale for pain and satisfaction (preinjury, preoperatively, and 12 months postoperatively; follow-up rate 90 %). MRI scans were analyzed according to the Genovese criteria.

RESULTS

Nineteen patients (29 %) showed a normal (A), 35 nearly normal (B), 5 abnormal (C), and 1 patient severely abnormal total IKDC score (D). The median Tegner preinjury score was 7 (range 2-10) and at follow-up 6 (range 2-10). The mean Lysholm score before surgery was 68 ± 20 and 93 ± 9 at follow-up. Preoperatively, the mean VAS pain was 4.4 ± 3.1 and 2.0 ± 1.0 at follow-up. Clinical failure of the CMI occurred in 3 patients (n = 1 infection, n = 1 failure of the implant, n = 1 chronic synovitis). On MRI, the CMI was completely resorbed in 3 patients (5 %), partially resorbed in 55 (92 %), and entirely preserved in 3 (5 %) patients. In 5 patients (8 %) the CMI was isointense, in 54 (90 %) slightly and 1 (2 %) highly hyperintense. 43 (72 %) patients showed an extrusion of the CMI implant of more than 3 mm.

CONCLUSIONS

Significant pain relief and functional improvement throughout all scores at 1 year was noted. The CMI undergoes significant remodeling, degradation, resorption, and extrusion in most of the patients. No difference in outcomes between the medial and lateral CMI was observed.

LEVEL OF EVIDENCE

Prospective therapeutic study, Level IV.